GPs' anger over Blair health reforms

How much trouble could the Government have when it tries to change the way general practitioners work?

New target

The National Plan for the NHS depends on significant changes to primary health care in England - with GPs carrying out far more procedures than they do at present. They'll also be expected to meet an ambitious new target: by the year 2004, patients will have a right to see a doctor within 48 hours of asking for an appointment.

Everyone agrees that this will need a considerable expansion in the number of GPs from the current total of 28,500. Tony Blair, when he announced the National Plan last week, promised an increase of two thousand by the year 2005, but there is growing scepticism about that figure.

Shortfall

GPs leaders complain that more than half the promised increase has already been announced: and that, for a number of reasons - including an imminent 'bulge' in the number of GP retirements - the real shortfall is far greater. The Royal College of GPs today suggested that 2,000 more family doctors were needed immediately.

A further problem concerns the plan to move away from the GP contracts which were first introduced when the NHS was established. These were based on what is sometimes called 'bean-counting' - payment according to the number of patients on a surgery's lists, and the number of procedures carried out.

Flexible contracts

The new Personal Medical Services contract, which is already being piloted, would be far more flexible. Its aim is to tailor a doctor's work to the needs of each particular area, and to make it easier to expand or alter the tasks each is required to fulfil.

I am convinced we can meet these targets

Health Minister, Lord Hunt

It's this move which is likely to prove the most contentious area of the negotiations between the Health Department and GPs. The junior Minister Lord Hunt insisted today that the new contracts would be voluntary - and that many doctors had already expressed their enthusiasm for the change. The Royal College of General Practitioners, however, warned that it would expect the new arrangements to offer real improvements.